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prior authorizations

CMS provides new details on prior auth process


WASHINGTON – CMS will turn around requests for prior authorizations for support surfaces in five business days, the agency announced during a Special Open Door Forum on Tuesday.

CMS will turn around expedited requests in two days, it says.

CMS shifts mobility codes into nat’l prior authorization program


WASHINGTON – CMS says a demonstration project requiring prior authorization requests for power mobility devices in 19 states will become permanent and will expand to all states.

Prior authorization kicks in for two complex rehab codes


WASHINGTON – CGS and Noridian on March 6 began accepting prior authorization requests for K0856 and K0861 for providers in Illinois, West Virginia, Missouri and New York. They are accepting requests for dates of delivery on or after March 20.

The year in HME News stories


YARMOUTH, Maine – 2016 was the year that HME providers fought back.

CMS ready to roll with prior authorizations


BALTIMORE – CMS is moving forward with its plans to implement a prior authorization process for certain DME and stakeholders say it should make life easier for providers.

CMS publishes prior auth rule


BALTIMORE – CMS today issued a final rule that would establish a prior authorization process for certain durable medical equipment.

Managed care mess: Providers struggle with new reality of serving Medicaid recipients


YARMOUTH, Maine – The increasing number of states turning to managed care to run their Medicaid programs is creating a logistical nightmare for providers.

‘Pressure’ is on to expand prior auths


YARMOUTH, Maine – CMS recently extended a demo requiring prior authorizations for certain power mobility devices, and providers say it may be time to consider other product categories, too.

Blackburn’s bill seeks to expand prior authorizations


WASHINGTON – Rep. Marsha Blackburn, R-Tenn., introduced a bill last week that would require prior authorizations for high-dollar DME.

CMS schedules special forum on PMD demo


WASHINGTON – CMS will host a Special Open Door Forum on Aug. 12 to allow DMEPOS suppliers and others to ask questions about the expanding PMD demon.